LAB SERVICES

Lab Services
Laboratory services are available in BARC. We collect samples from 10am to 6pm. Routine Lab reports are available in 3 hours time after obtaining the samples on the same day. This facilitates quick and prompt care. Special tests like synovial (joint) fluid analysis, musculoskeletal ultrasound can also be done. The following lab tests are available in BARC: ESR, CBC CRP ANA Anti ds DNA ASO titre Rheumatoid Factor Anti CCP ANA Profile ANCA Complement Assay - C3, C4 Complete urine examination Anti Phospholipid antibodies             Lupus anti coagulant, Anti cardio lipin antibody  Serum protein electrophoresis Synovial fluid crystals (polarized microscope) Renal profile Liver function tests Brucella IgM, HBs Ag, HCV, Mx test

SERVICES BARC

Services Detailed clinical assessment of all rheumatology problems by a senior Rheumatologist with the aids of computerised scoring systems to evaluate disease activity or damage and response to therapy. Laboratory facilities for all immunological tests like Rheumatoid factor, Anti CCP, AWA, Anti dsDNA, ANA profile, ANCA etc. Excellent pharmacy specialized to cater the needs of arthritis patients.  All costly or imported biological drugs are provided at the lowest possible rates. Other facilities going to be available soon. Online access of investigation results and prescription of patients. Teleconferencing & net meeting for urgent opinion for patients staying far from the centre. Patient education through booklets in local languages. Classes on Arthritis & Rheumatologic diseases by doctors and health care providers. Physiotherapy facilities for Rheumatological disorders. DISEASES TREATED WITH SPECIAL CARE IN BARC Rheumatoid Arthritis Seronegative spondyloarthritis Ankylosing spondylitis Psoriatic arthritis Reactive arthritis Reiter’s syndrome Arthritis associated with Crohn’s disease and ulcerative colitis Connective tissue disease Systemic Systemic lupus erythematosus Progressive systemic sclerosis Mixed connective tissue disease Polymyositis - Dermatomyositis Gout and Pseudogout Osteoarthritis Vasculitis Aortoarteritis Wegener’s granulomatosis Behcet’s syndrome Polyarteritis nodosa Fibromyalgia Regional pain syndrome Low back pain Osteoporosis
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BARC LOCATION

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RHEUMATOLOGY CALICUT

Welcome to BARC A specialised centre providing state of the art comprehensive health care to those who are living with arthritis or Rheumatic diseases.  This arthritis centre has a knowledgeable team led by a senior Rheumatologist whose experience for caring and managing arthritis spans over more than 24 years. This modern and efficient centre is situated right in the heart of Calicut (Kozhikode) city to provide ultra modern facilities in investigations and therapy of arthritis to a larger section of population.		Dr .Binoy J Paul Dr. Binoy J Paul completed MBBS and MD (Medicine) From Medical College, Kottayam.  He completed a PhD in Rheumatology from Calicut University.  He also did a fellowship programme in Rheumatology from Manchester, UK.  He is a Diplomate of National Board – DNB. He worked in Govt. Medical College, Calicut for more than 20 years.  Presently working as Managing Director- Dr. Binoy’s Arthritis & Rheumatism Centre (BARC), Calicut. He is a Member of British Society of Rheumatology and Member of Asia Pacific League Against Rheumatism (APLAR). He was the former secretary of IMA – AMS Calicut Branch, Former National Secretary of Indian Rheumatology Association.
Services Detailed clinical assessment of all rheumatology problems by a senior Rheumatologist with the aids of computerised scoring systems to evaluate disease activity or damage and response to therapy. Laboratory facilities for all immunological tests like Rheumatoid factor, Anti CCP, AWA, Anti dsDNA, AWA profile, ANCA etc. Excellent pharmacy specialized to cater the needs of arthritis patients.  All costly or imported biological drugs are provided at the lowest possible rates. Other facilities going to be available soon.	Laboratory Laboratory services are available in BARC. We collect samples from 10am to 6pm. Routine Lab reports are available in 3 hours time after obtaining the samples on the same day. This facilitates quick and prompt care. Special tests like synovial (joint) fluid analysis, musculoskeletal ultrasound can also be done.
Dr.Binoy's Arthritis & Rheumatism Centre

DR BINOY

RHEUMATOLOGIST IN KERALA

DR BINOY J PAUL

CEO DR .BINOY'S ARTHRITIS AND RHEUMATOLOGY CENTRE
 PHONE NUMBERS 04952740195,9249274681

Crystal Arthritis - Past, Present and Future Binoy J. Paul

T h e   c r y s t a l   r e l a t e d   a r t h r o p a t h i e s   r e p r e s e n t   a
heterogenous group of disorders in which minerals are
d e p o s i t e d   i n  mu s c u l o s k e l e t a l   t i s s u e   r e s u l t i n g   i n
pathological alterations. Intra articular crystals can cause
acute and chronic inflammation and joint damage via
biomechanical and biochemical pathways.The most
common crystal related arthopathies are Gout, Calcium
pyrophosphate dihydrate disease (pseudogout) and
calcific periarthritis/ tendonitis (Basic calcium phosphate
crystal deposition disease). Of these gout is the most
common but easily misdiagnosed problem in day to day
practice. “ Screw up the vice as tightly as possible - you
have rheumatism, give it another turn and that is gout”
-  Anonymous
The word Gout is derived from the latin word ‘gutta’
means drop. It is based on the ancient belief that the
arthritis is due to deposition of malevolent humor by
evil spirits into the joint, drop by drop (1). Way back in
the 4
th
 century BC, Hippocrates made astute observations
about gout which is popularly known as “aphorisms of
gout” He said that “Eunuchs do not take gout, nor become
bald. A women does not take gout unless her menses be
stopped,An young man does not take gout unless he
indulges in coitus. In gouty affection, inflammation
subsides in 40 days”. In 3rd century BC, Galen described
the tophi. Crystals  in gouty tophi was first demonstrated
by Antony Van Leeuwenhoek in 1679 (2). It is in 1848
Sir Alfred Garrod demonstrated hyperuricemia as the
basic cause of gout (3). In 1961 McCarty and Hollander
established the association between  gouty arthritis and
articular crystal deposition
Gout is a clinical syndrome occurs as a result of
deposition of monosodium urate monohydrate crystals
from hyper uricemic body fluids. The crystals may be
deposited in a joint leading to an acute inflammatory
response or in soft tissues such as cartilage causing no
inflammation. Most cases of gout are characterised by the
sudden onset of severe acute mono arthritis in a peripheral
joint in the lower limb. The arthritis remits completely
and  then  r e cur s  wi th  inc r e a s ing  f r equency.  Af t e r
approximately 10 years of recurrent gouty arthritis, tophi
develop in cartilage, tendons and bursae in some patients.
There is a marked increase in incidence of gout in
certain parts of  India like Kerala in the recent years.
Rapid urbanisation with change in lifestyle leading to
obesity, lack of physical exercise, high protein diet,
alcoholism and increasing use of drugs like  thiazides
are some of the causes for this rise in the  incidence.
Gout was extremely rare in menstruating females due
to the uricosuric effect of estrogen. However the
incidence of female gout is also rising in India due to
increased longevity after menopause ,change in life style,
increasing number of hysterectomies and use of various
hyperuricemic drugs
The gold standard for diagnosis of gout is joint
aspiration and identification of characteristic needle
s h a p e d   n e g a t i v e l y   b i r e f r i n g e n t   m o n o   s o d i u m
nitrate crystals under compensated polarized light
microscopy (4). Gram stain and culture of the aspirated
fluid are often performed concomitantly to exclude septic
arthritis and cellulites both of which may mimic acute
gout. When crystals are not identified and culture is
negative a presumptive diagnosis of gout is often made
on the basis of other factors including a classic clinical
presentation ( eg. Podagra) positive family history, hyper
ur i c emi a   and  r apid  r e solut ion of   symptoms  wi th
colchicine.